Early pregnancy disorders: expert knowledge based consultation

The study presents a part of the knowledge-based consultation system for use in a gynecological primary health service to assist doctors who might not be highly experienced, such as junior gynecologists or general practitioners working in small centers, rural areas, developing countries, etc. Aiding the prompt detection of early pregnancy disorders has been considered to reduce complications in these cases, including the life-threatening ones. Although imminent abortion or ectopic pregnancy is usually assumed, all 17 diagnostic hypotheses manifested through similar symptoms are provided. A special experts' knowledge base including 12,000 rules formulated according to the ELSA-method (Experts Lattice Structured Acquirements) principles has been completed for this purpose. The following pattern serves for obtaining experts acquirements: IF (diagnostic problem) AND (manifestation) THEN (diagnostic hypothesis A) R (diagnostic hypothesis B) where R denotes one of the following relations: ... "preferred rather than"..., ... "preferred strongly to" ..., ... "equivalent to" ... A special procedure has been developed for processing these experts judgements to aid the medical reasoning in complex situations. The consultation system offers its assistance in: --differentiation within any given group of diagnostic hypotheses through setting them in order dependent on the patient's manifestations presented, --selection of the most efficient diagnostic steps for differentiating within the diagnostic hypotheses assumed. A consultation in the case of the patient with irregular vaginal bleeding has been included. The system operates on IBM PC/XT, equipped with 256 RAM, 360 kB floppy and a printer.